Child asthma steroids cut by tests

Scientists say that testing the breath and phlegm of children who have severe asthma could help detect early signs of the condition getting worse.

The team from Imperial College London also indicated this may spare children having to take potentially damaging oral steroid drugs.

National guidelines already recommend the use of sputum tests but the researchers say the breath and phlegm tests may allow the worsening asthma to be brought back under control and could cut the use of oral steroids by nearly a third over a three-year period.

Professor Andrew Bush, who led the research, said: "It’s a much more efficient way of making sure children with severe asthma get the treatment they need."

Many children already use a steroid inhaler but when if this is not effective, doctors can give higher doses of steroids, though they prefer not to use these so-called "rescue steroids" because of the side effects that can include growth problems.

The ICL tests looked for signs of increasing lung inflammation and higher than usual levels of nitric oxide gas in the breath, which may appear before the asthma worsened, giving doctors the time to increase the dose of steroid inhaler.

They compared the progress of children assessed using symptoms and lung function tests - the conventional way - with a group given the sputum and breath tests.

Researcher Dr Louise Fleming explained the aim was not only to reduce the number of severe attacks, but to make sure that children were not on too high a dose of inhaled steroids all the time.